Patho Test 3 NCLEX
A patient tells the nurse, "I was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was so slow." What does the nurse understand occurred with this patient?
patient had a vagal response
The heart is a four-chambered pump. What is the function of the right ventricle?
pumps blood to the lungs
The nurse is preparing to administer adenosine for a patient diagnosed with atrial flutter. How should the nurse administer this medication?
rapid iv push
The clinic nurse is assessing a client's pulse before outpatient diagnostic testing. What should the nurse document when assessing the client's pulse?
rate, quality, rhythm
What does decreased pulse pressure reflect?
reduced stroke volume
Pain that is felt in a different body part to the source of the pain is called?
referred pain
Which sequence is the correct pathway for blood flow through the heart?
right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta
The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)?
hypokalemia
The nurse assesses a client with a heart rate of 120 beats per minute. What are the known causes of sinus tachycardia?
hypovolemia
Age-related changes associated with the cardiac system include which conditions? Select all that apply.
increased size of the left atrium endocardial fibrosis
The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate?
international normalized ratio (INR)
The nurse is caring for a client who is diagnosed with an infarction of the posterior wall of the right atrium. Which assessment finding would the nurse anticipate relating to the infarction location?
irregular heart rate
Which of the following blood flow patterns reduces friction, allowing the blood layers to slide smoothly over one another?
laminar
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving oxygenated blood from the lungs?
left atrium
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body?
left ventricle
The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation?
left ventricle
The system responsible for an individual's emotional and behavioral responses to pain is the?
motivational/affective system
Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissues?
nitric oxide
The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following?
Chordae tendineae
A 56-year-old male is diagnosed with CAD. Which of the following modifiable factors would most likely influence development of the disease?
Cigarette smoking
______ atelectasis is the collapse of lung tissue caused by external pressure exerted by a tumor, fluid, or air.
Compression
Which structure within the myocardium contains gap junctions that allow impulses to travel rapidly so the heart can contract as a single unit?
Intercalated disks
A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of Creatine phosphate and lactic dehydrogenase. These elevated levels indicate:
Myocardial infarction
The nurse admits an adult female client with a medical diagnosis of "rule out MI." The client is very frightened and expresses surprise that a woman would have heart problems. What response by the nurse will be most appropriate?
"A woman's heart is smaller and has smaller arteries that become occluded more easily."
Two nursing students are reading EKG strips. One of the students asks the instructor what the P-R interval represents. The correct response should be which of the following?
"It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node."
The nurse is speaking with a client admitted with a dysrhythmia. The client asks the nurse to explain the "F waves" on the electrocardiogram. What is the nurse's best response?
"The F waves are flutter waves representing atrial activity."
The nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. What is the nurse's best reply?
"The only difference is the heart rate."
The nurse is caring for a client who had a permanent pacemaker surgically placed and is now ready for discharge. What statement made by the client indicates the need for more education?
"We will be getting rid of our microwave oven so it will not affect my pacemaker."
A client asks why he has not had major heart damage since his cardiac catheterization revealed he has 98% blockage of the right coronary artery. The nurse's best response is:
"You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked."
A nurse recalls acute orthostatic hypotension can be caused by (select all that apply):
- Prolonged immobility - Drug action - Starvation - Volume depletion
A 50-year-old male crushed his hand while working in a sawmill. Long after his injury has healed he still feels burning pain in his hand. This pain is referred to as?
Neuropathic pain
After performing an ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm?
0.12 and 0.2 seconds.
The nurse knows that what PR interval presents a first-degree heart block?
0.24 seconds
A client experiences a faster-than-normal heart rate when drinking more than two cups of coffee in the morning. What does the nurse identify on the electrocardiogram as an indicator of sinus tachycardia?
118
A patient has been researching cardiac cells on the internet. Which information indicates the patient has a good understanding? Cardiac cells can withstand ischemic conditions for ___ minutes before irreversible cell injury occurs.
20
Cardiac cells can withstand ischemic conditions for ___ before irreversible injury occurs?
20 minutes
Chronic pain is pain that has lasted longer than?
3 months
The cardiac reserve refers to the maximum percentage of increase in cardiac output that can be achieved above the normal resting level. What is the normal young adult's percentage cardiac reserve?
300% - 400%
Which of the following measures is most effective for preventing pulmonary emboli in patients who are recovering from a major surgery? A) Ambulate patients frequently to prevent blood clot formation. B) Ensure that patients use supplemental oxygen. C) Prevent the development of anemia. D) Promote aggressive fluid intake.
A) Ambulate patients frequently to prevent blood clot formation.
A client is diagnosed with an abdominal aortic aneurysm that the physician just wants to "watch" for now. When teaching the client about signs/symptoms to watch for, the nurse will base the teaching on which physiologic principle?
As the aneurysm grows, more tension is placed on the vessel wall, which increases the risk for rupture.
Individuals who have recently developed chronic bronchitis most often present with: A) productive cough. B) wheezing. C) a barrel chest. D) severe dyspnea.
A) productive cough.
Air that enters the pleural space during inspiration and is unable to exit during expiration creates a condition called: A) tension pneumothorax. B) open pneumothorax. C) pleural effusion. D) empyema.
A) tension pneumothorax.
Airway obstruction in chronic bronchitis is generally the result of: A) thick mucous secretions and smooth muscle hypertrophy. B) loss of alveolar elastin. C) the accumulation of pulmonary edema. D) hyperplasia of bronchial cartilage.
A) thick mucous secretions and smooth muscle hypertrophy.
A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which factor has most likely resulted in the client's increased blood pressure?
Activation of the renin-angiotensin-aldosterone mechanism
The nurse knows that there are many different groups of antihypertensive drugs having varied mechanisms of action. Which medication decreases the exit of adrenergic (sympathetic) stimulation from the central nervous system, thereby decreasing sympathetic outflow
An alpha-2 adrenergic agonist
A postsurgical client reports calf pain combined with the emergence of swelling and redness in the area, which has lead to a diagnosis of deep vein thrombosis (DVT). What treatment option will be of greatest benefit to prevent further thrombus formation?
Anticoagulation therapy and elevation of the leg
The heart consists of four valves. Which are the semilunar valves? Select all that apply.
Aortic and pulmonary
Coronary artery bypass grafting (CABG) is a treatment modality for which disorder of cardiac function?
Atherosclerosis and unstable angina
The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle?
Atrial depolarization
A nurse is checking laboratory values on a client who has crackles in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which laboratory value does the nurse expect to be abnormal?
B-type natriuretic peptide (BNP)
Pulmonary emphysema is characterized by a number of derangements of pulmonary structure and function. Which of the following is NOT a feature of pulmonary emphysema? A. Chronic inflammation of bronchioles leads to trapping of air in the lungs. B. Flow of air in and out of the lungs is greatly increased. C. Nonuniform ventilation of alveoli reduces the efficiency of ventilation. D. Enlargement of air spaces and reduction of capillary surface area within the lungs reduces the efficiency of gas exchange. E. A loss of lung elasticity requires active expiratory effort.
B. Flow of air in and out of the lungs is greatly increased.
A client's echocardiogram identified a narrowed valve that has resulted in a decreased blood flow between the left atria and left ventricle. The nurse would interpret this as the:
Bicuspid valve
Persistent cyanosis has led an infant's care team to suspect a congenital heart defect. Which assessment findings would suggest coarctation of the infant's aorta?
Blood pressure in the child's legs is lower than in the arms.
Which of the following lab tests will the nurse check to help diagnose heart failure and provide insight into its severity?
Brain na triuretic
Which of the following characteristics is not typical of asthma? A) Asthma is a chronic inflammatory disorder. B) Asthma is caused by bronchial hyperresponsiveness. C) Asthma causes alveolar collapse. D) Genetic susceptibility plays a role in the development of asthma.
C) Asthma causes alveolar collapse.
Primary pulmonary hypertension usually is caused by: A) chronic pulmonary disease. B) right-sided heart failure. C) hereditary traits. D) pulmonary emboli.
C) hereditary traits.
The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by: A) increased pulmonary blood flow. B) increased expiratory flow rates. C) increased residual lung volumes. D) decreased chest wall compliance.
C) increased residual lung volumes.
A life-threatening complication of asthma is: A) exercise-induced asthma. B) chronic obstructive pulmonary disease. C) status asthmaticus. D) bronchiectasis.
C) status asthmaticus.
Pneumonia leads to hypoxemia due to: A) cardiogenic pulmonary edema. B) upper airway obstruction. C) the accumulation of exudates and fibrin deposition. D) the decreased fraction of inspired oxygen.
C) the accumulation of exudates and fibrin deposition.
Cardiac output (CO) is used to measure the efficiency of the heart as a pump. What is the equation used to express CO?
CO = SV X HR. The efficiency of the heart as a pump often is measured in terms of cardiac output (CO) or the amount of blood the heart pumps each minute. The CO is the product of the stroke volume (SV) and the heart rate (HR), and can be expressed by the equation: CO = SV X HR. AV stands for atroventricular and EF stands for ejection fraction. Neither is part of the equation for CO.
Select the correct sequence of blood return to the heart.
Capillaries, venules, veins, right atrium
Based on assessment, a nurse suspects the client may be experiencing heart failure. Which diagnostic test would be the best indicator to determine pressure being exerted on the right side of the heart?
Central venous pressure
A nurse is caring for a client with a central venous pressure (CVP) of 4 mm Hg. Which nursing intervention is appropriate?
Continue to monitor the client as ordered. Normal CVP ranges from 2 to 6 mm Hg. The nurse doesn't need to take any action other than to monitor the client. It isn't necessary to re-zero the equipment. Calling a health care provider and obtaining an order for a fluid bolus would be an appropriate intervention if the client has a CVP less than 2 mm Hg. Administering a diuretic would be appropriate if the client had excess fluid, as demonstrated by a CVP greater than 6 mm Hg. (Note: normal values can vary by reference source.)
The heart controls the direction of blood flow. What is the role of the aortic valve?
Controls the direction of blood flow from the left side of the heart to the systemic circulation
_____ is a term that signifies right-sided heart failure secondary to pulmonary hypertension.
Cor pulmonale
A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:
Correct Answer: Abnormal thickening and hardening of vessel walls Response Feedback: Atherosclerosis is a form of arteriosclerosis characterized by thickening and hardening of the vessel wall.
A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down. She has a fever, tachycardia, and a friction rub. Based upon the assessment findings, the nurse determines the patient is experiencing:
Correct Answer: Acute pericarditis Response Feedback: Severe chest pain that worsens with respirations or lying down in a patient with fever, tachycardia, and a friction rub is characteristic of acute pericarditis.
A 49-year-old male presents to his primary care provider reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?
Correct Answer: Apply oxygen to increase myocardial oxygen supply. Response Feedback: Increase myocardial oxygen supply is indicated to treat ischemia.
When a patient asks the nurse what is the most common cause of myocardial ischemia, which statement is the correct response? The most common cause of myocardial ischemia is:
Correct Answer: Atherosclerosis Response Feedback: The most common cause of myocardial ischemia is atherosclerosis.
A 60-year-old male is diagnosed with cerebral aneurysm. Where does the nurse suspect the cerebral aneurysm is located?
Correct Answer: Circle of Willis Response Feedback: Cerebral aneurysms often occur in the circle of Willis.
Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms?
Correct Answer: Cold exposure Response Feedback: Raynaud disease consists of vasospastic attacks triggered by brief exposure to cold.
A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:
Correct Answer: Deep veins of the leg Response Feedback: The most likely origin of the embolism is from the deep veins of the legs.
A nurse monitors the patient for _____ when rapid onset of malignant hypertension results.
Correct Answer: Encephalopathy Response Feedback: Malignant hypertension leads to cerebral edema and cerebral dysfunction (encephalopathy) and even death.
A patient wants to know what causes atherosclerosis. How should the nurse respond? In general, atherosclerosis is caused by:
Correct Answer: Endothelial injury and inflammation Response Feedback: Atherosclerosis begins with injury to the endothelial cells that line artery walls.
A 30-year-old Caucasian female was recently diagnosed with primary hypertension. She reports that she eats fairly well, usually having red meat and potatoes daily. She also reports that her father has hypertension as well. A nurse determines which of the following risk factors is most likely associated with this diagnosis?
Correct Answer: Genes Response Feedback: Genetic factors, such as family history of hypertension, are the number one factor in the development of hypertension.
A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. He most likely has:
Correct Answer: Impending myocardial infarction (MI) Response Feedback: Unstable angina is an indication of impending MI.
A 59-year-old female is diagnosed with left ventricular failure. If a decrease in kidney perfusion occurs, the nurse knows this would ultimately cause:
Correct Answer: Increased systemic vascular resistance Response Feedback: With a decrease in kidney perfusion, renin is released with the ultimate outcome of increased systemic vascular resistance to raise blood pressure to increase blood flow to the kidney.
A 52-year-old female is diagnosed with coronary artery disease. The nurse assesses for myocardial:
Correct Answer: Ischemia Response Feedback: Coronary artery disease leads to myocardial ischemia.
A 73-year-old female has increased pulmonary pressure resulting in right heart failure. The nurse should monitor for a possible complication because a potential cause for her heart to fail is:
Correct Answer: Left heart failure Response Feedback: Right-sided failure often follows left-sided failure when pulmonary congestion forces backward flow of blood into the left ventricle.
Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:
Correct Answer: Left ventricular preload increases. Response Feedback: Left ventricular preload increases in left heart failure because less blood is ejected from the left ventricle.
A 56-year-old male presents to his primary care provider for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse?
Correct Answer: Tamponade Response Feedback: Muffled heart sounds is an indication of tamponade, and with tamponade the blood backs up into the venous system, leading to hepatomegaly.
A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins?
Correct Answer: Long periods of standing Response Feedback: The probable cause of the patient's varicose veins is gradual venous distention caused by the action of gravity on blood in the legs due to long periods of standing. Varicose veins are most likely due to long periods of standing leading to the action of gravity promoting venous distention. Exercise would help prevent this. Trauma can occur, but usually this affects the more superficial veins. Ischemia affects arteries not veins.
A staff member asks a nurse what foam cells are. What is the nurse's best response? Foam cells in a fatty streak are:
Correct Answer: Macrophages that engulf low-density lipoprotein (LDL) Response Feedback: Foam cells are lipid-laden macrophages that engulf LDL.
A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to:
Correct Answer: Myocardial hypertrophy and ventricular remodeling Response Feedback: With hypertension comes increased afterload and resistance to ventricular emptying and more workload for the ventricle, which responds with hypertrophy of the myocardium and ventricular remodeling.
A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of cardiac troponins I and T. Based upon the lab findings, the nurse suspects which of the following has occurred?
Correct Answer: Myocardial infarction (MI) Response Feedback: The diagnosis of acute MI is made on the basis of serial cardiac biomarker alterations. The cardiac troponins (troponins I and T) are the most specific indicators of MI.
A 55-year-old male died of a myocardial infarction. Autopsy would most likely reveal:
Correct Answer: Platelet aggregation within the atherosclerotic coronary artery
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.
Correct Answer: Primary Response Feedback: Most cases of hypertension are diagnosed as primary hypertension.
A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?
Correct Answer: Prinzmetal Response Feedback: Chest pain that occurs at rest and at night is descriptive of Prinzmetal angina. Unstable angina is a form of acute coronary syndrome that results from reversible myocardial ischemia. Stable angina is predictable and occurs with activity. Silent angina has few, if any, symptoms.
When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of:
Correct Answer: Pulmonary vascular congestion Response Feedback: The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation.
65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient?
Correct Answer: Right heart failure Response Feedback: Right-sided failure occurs when the patient experiences chronic pulmonary disease and elevated pulmonary vascular resistance because the blood has difficulty overcoming the pressure and blood builds up in the right side of the heart.
A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?
Correct Answer: Significant edema to both lower legs and feet Response Feedback: Right-sided failure allows blood to back up into the systemic circulation, leading to peripheral edema.
A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change?
Correct Answer: Smoking cigarettes Response Feedback: Cigarette smoking leads to vasoconstriction and should be the first behavior the patient changes.
A 51-year-old male is at the health clinic for an annual physical exam. After walking from the car to the clinic, he developed substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. The nurse suspects he is most likely experiencing:
Correct Answer: Stable angina Response Feedback: Stable angina is associated with activity and subsides with rest.
When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do?
Correct Answer: Stand up Response Feedback: Orthostatic hypotension refers to a drop in blood pressure when standing up.
A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure. The nurse understands this is most likely caused by:
Correct Answer: Sympathetic nervous system compensation for decreased cardiac output Response Feedback: The sympathetic nervous system increases peripheral vascular resistance (PVR) and leads to hypertension.
A 50-year-old male is diagnosed with orthostatic hypotension. Which of the following symptoms would he most likely experience?
Correct Answer: Syncope and fainting Response Feedback: Orthostatic hypotension is often accompanied by dizziness, blurring or loss of vision, and syncope or fainting.
A nurse takes an adult patient's blood pressure and determines it to be normal. What reading did the nurse obtain?
Correct Answer: Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg Response Feedback: Normal blood pressure has a systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg. A systolic pressure of 140 mm Hg or more would indicate stage I hypertension. A systolic pressure of less than 100 mm Hg would indicate low blood pressure. A diastolic pressure greater than 90 mm Hg would indicate hypertension.
59-year-old female is diagnosed with left ventricular failure. The decrease in kidney perfusion would ultimately cause
Increased systemic vascular resistance*
A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when:
Correct Answer: The myocardial oxygen supply has fallen below demand. Response Feedback: Angina is chest pain caused by myocardial ischemia, which develops if the flow or oxygen content of coronary blood is insufficient to meet the metabolic demands of myocardial cells.
A 60-year-old female had a myocardial infarction. She was brought to the hospital 30 minutes later. She survived, but now the nurse is providing care for impaired ventricular function because:
Correct Answer: The resulting ischemia leads to hypoxic injury and myocardial cell death. Response Feedback: The patient has impaired ventricular functioning because a portion of the myocardium has died due to ischemia.
A 65-year-old female presents to the emergency department reporting difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the:
Correct Answer: Thoracic aorta Response Feedback: Thoracic aortic aneurysms can cause dysphagia (difficulty swallowing) and dyspnea (breathlessness).
What term should the nurse document for a detached blood clot?
Correct Answer: Thromboembolus Response Feedback: A detached thrombus is a thromboembolus.
A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling. He has an elevated level of low-density lipoprotein (LDL) and a low level of high-density lipoprotein (HDL). Which of the following should the nurse advise him to avoid?
Correct Answer: Trans fats Response Feedback: Trans fats are primarily found in artificially solidified (hydrogenated) oils (e.g., margarine and vegetable shortening). By becoming more solid, they lose essential fatty acids (EFAs). They can raise LDL and lower HDL levels.
A 32-year-old female presents with lower leg pain, with swelling and redness. While obtaining the patient's history, which finding could have caused her condition?
Correct Answer: Venous thrombus Response Feedback: A thrombus formation in the vein leads to inflammation that may cause pain and redness with obstruction. Increased pressure in the vein behind the clot may lead to edema of the extremity.
The clinic nurse caring for a client with a cardiovascular disorder is performing an assessment of the client's pulse. Which of the following steps is involved in determining the pulse deficit?
Count the heart rate at the apex.
When intracranial pressure (ICP) equals intra-arterial pressure, the central nervous system ischemic response is initiated. This response is directed at raising arterial pressure above ICP, thereby reestablishing blood flow to the vasomotor center of the brain. What is this response called?
Cushing reflex
A client has been prescribed a thiazide diuretic, hydrochlorothiazide (HCTZ), for the initial treatment of hypertension. What effect does the nurse know this drug will have on the body to consequently decrease blood pressure?
Decrease vascular volume
A client has just experienced stimulation of the vagus nerve. Which sign would the nurse anticipate the client to manifest?
Decreased heart rate
A client is experiencing a sudden increase in heart rate resulting in less time in diastole. This can result in which potential complication?
Decreased stroke volume
The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block?
Delayed conduction, producing a prolonged PR interval
The nurse is caring for a geriatric client. The client is ordered Lanoxin (digoxin) tablets 0.125mg daily for a cardiac dysrhythmia. Which of the following assessment considerations is essential when caring for this client?
Digoxin level
The nurse knows that which group of antihypertensive drugs is usually the least expensive and are well tolerated?
Diuretics
The nurse caring for a client who is suspected of having cardiovascular disease has a stress test ordered. The client has a co-morbidity of multiple sclerosis, so the nurse knows the stress test will be drug-induced. What drug will be used to dilate the coronary arteries?
Dobutamine Drugs such as adenosine (Adenocard), dipyridamole (Persantine), or dobutamine (Dobutrex) may be administered singularly or in combination by the IV route. The drugs dilate the coronary arteries, similar to the vasodilation that occurs when a person exercises to increase the heart muscle's blood supply. Options A, B, and C would not dilate the coronary arteries.
The nurse is assessing a client with mitral regurgitation. The nurse expects to note what finding in this client?
Dyspnea, fatigue, and weakness
The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. What explanation will the nurse offer to explain the urination?
Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys.
The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia?
Elective cardioversion
An older adult client's blood pressure (BP) is 120/80 mm Hg when in a lying position. When the nurse retakes the client's BP in a sitting position, the BP is 92/60 mm Hg. Which intervention is appropriate for the nurse to implement?
Encouraging the client to maintain hydration throughout the day
Pregnancy-induced hypertension is a serious condition affecting between 5% and 10% of pregnant women. The most serious classification of hypertension in pregnancy is preeclampsia-eclampsia. It is a pregnancy-specific syndrome that can have both maternal and fetal manifestations. What is a life-threatening manifestation of the preeclampsia-eclampsia classification of pregnancy-induced hypertension?
HELLP Syndrome
A 49-year-old male presents to his physician complaining of chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia (inadequate blood flow). Which of the following interventions would be most beneficial?
Increase myocardial oxygen supply
A grandmother who works as a cook at a nearby school was recently hospitalized when she lost an extensive amount of blood in a work-related accident. The grandmother tells the nurse that she heard that she would keep feeling faint until the brain made more blood. The nurse knows that when the blood pressure dropped, the pressure in the carotid arteries decreased. This was detected by baroreceptors in the carotid arteries. What did the baroreceptors do?
Increase sympathetic stimulation of the heart and blood vessels
A client took a weight loss drug that activated the alpha-adrenergic receptors in the sympathetic nervous system. Which manifestations would the nurse expect to occur? Select all that apply.
Increased blood pressure of cardiac contraction Increased cardiac cycle speed
Which of the following is true regarding pulmonary circulation?
It is a low-pressure system that allows for improved gas exchange.
A 73-year-old female has increased pulmonary pressure resulting in right heart failure. A potential cause for her heart to fail is:
Left heart failure
Which related circulatory complication can result from surgical treatment for metastatic breast cancer?
Lymphedema in the affected arm
While the nurse is preparing a client for a cardiac catheterization, the client states that they have allergies to seafood. Which of the following medications may the nurse give prior to the procedure?
Methylprednisolone
Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia?
Monitor vital signs and cardiac rhythm
A client who developed a deep vein thrombosis during a prolonged period of bed rest has deteriorated as the clot has dislodged, resulting in a pulmonary embolism. Which type of shock is this client at risk of experiencing?
Obstructive shock
A client with a long history of stable angina suddenly experiences substernal pain that radiates to the left arm, neck, and jaw. He describes the pain as severe and feels as if he is suffocating. He has taken nitroglycerin and not experienced any relief. The client is most likely experiencing:
Onset of STEMI
A nurse is assessing a client diagnosed with severe mitral valve stenosis. The nurse anticipates which classic assessment finding?
Orthopnea
The lowest intensity that of a stimulus that is perceived as painful is termed?
Pain threshold
A client admitted to the telemetry unit has a serum potassium level of 6.6 mEq/L. Which electrocardiographic (ECG) characteristic is commonly associated with this laboratory finding?
Peaked T waves
A client is seen in the emergency room reporting sharp chest pain that started abruptly. He says it has radiated to his neck and abdomen. He also states that it is worse when he takes a deep breath or swallows. He tells the nurse that when he sits up and leans forward the pain is better. Upon examination the nurse notes a pericardial friction rub and some EKG changes. Which disease should the nurse suspect this client to have?
Pericarditis
On a holiday trip home, the nurse's mother states that the nurse's father was diagnosed with right-sided heart failure. Which manifestation exhibited by the father does the nurse know might have preceded this diagnosis?
Peripheral edema, weight gain
What is inflammation of the pleura that causes pain on inspiration called?
Pleurisy
A nurse is teaching a client the correct technique for taking an arterial pulse. The nurse explains that the pulsations are:
Pressure pulses
The nurse is assessing a patient's blood pressure. What does the nurse document as the difference between the systolic and the diastolic pressure?
Pulse pressure
When a client is experiencing a parasympathetic nervous system response to severe chest pain, the nurse will likely see which change in the client's vital signs?
Pulse rate below 59 beats/minute
A client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client?
Raynaud disease
An 85-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures generally results from this condition?
Right heart failure ---Right ventricle pumps to the pulmonary veins- resistance making it hard for the flow of blood from the RV→ Lungs
The nurse is assessing heart sounds in a patient with heart failure. An abnormal heart sound is detected early in diastole. How would the nurse document this?
S3
The nurse observes a client during an exercise stress test (bicycle). Which finding indicates a positive test and the need for further diagnostic testing?
ST-segment changes on the ECG
Inflammation in visceral tissues activates?
Silent nociceptors
The nurse is teaching a beginning EKG class to staff nurses. As the nurse begins to discuss the parts of the EKG complex, one of the students asks what the normal order of conduction through the heart is. What order does the nurse describe?
Sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, right and left bundle branches, and the Purkinje fibers
A 15-year-old female scrapes her knee while playing soccer and complains of sharp and well-localized pain. What would most accurately characterise her pain?
Somatic pain
A 26-year-old client, who has been diagnosed with paroxysmal supraventricular tachycardia (PSVT), is treated in the emergency department. The client is experiencing occasional runs of PSVT lasting up to several minutes at a time. During these episodes, the client becomes lightheaded but does not lose consciousness. Which maneuver(s) may be used to interrupt the client's atrioventricular nodal reentry tachycardia (AVNRT)? Select all that apply.
Stimulating the client's gag reflex Placing the client's face in cold water Performing carotid massage
The difference between the end-diastolic and end-systolic volumes is called what?
Stroke volume
Which one of the following is an excitatory neuromodulator that enhances pain transmission? Beta endorphin, encephalin, substance P, dynorphin
Substance P
A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for:
Tearing or ripping-type pain in the chest or back
The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply.
The arterial system distributes oxygenated blood to the tissues. The venous system collects deoxygenated blood from the tissues.
The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system?
The kidneys
Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching?
The patient smokes cigarettes
The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated?
The registered nurse administering atropine sulfate intravenously
A 55 year old male presented to his doctor complaining of severe headache. Investigative tests suggested his pain was psychogenic in nature. Why?
This type of pain appears to have no underlying pathology
The troponin complex is one of a number of important proteins that regulate actin-myosin binding. Troponin works in striated muscle to help regulate calcium-mediated contraction of the muscle. Which of the troponin complexes is diagnostic of a myocardial infarction?
Troponin T and troponin I
The nurse identifies the blood vessel layer that constricts to regulate and control diameter as:
Tunica media
Which blood vessel layer is made primarily of muscle?
Tunica media
Preload, the stretch on the heart before contraction, is largely determined by which factor?
Venous blood return
A client has a blood pressure of 68/38 mm Hg and fainted after donating a unit of blood. The client is experiencing low preload from loss of blood volume. What is preload?
Venous return to the heart
The cardiac cycle describes the pumping action of the heart. Which statement is correct about systole?
Ventricles contract and blood is ejected from the heart.
The nurse is working on a monitored unit assessing the cardiac monitor rhythms. Which waveform pattern needs attention first?
Ventricular fibrillation Ventricular fibrillation is called the rhythm of a dying heart. It is the rhythm that needs attention first because there is no cardiac output, and it is an indication for CPR and immediate defibrillation. Sustained asystole either is from death, or the client is off of the cardiac monitor. Supraventricular tachycardia and atrial fibrillation is monitored and reported to the physician but is not addressed first.
A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi?
Warfarin (Coumadin)
Which neurotransmitter is associated with the parasympathetic nervous system?
acetylcholine
The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client?
alerting the healthcare provider of the third-degree heart block
The pain that occurs to a stimulus such as light stroking that normally does not provoke pain is termed?
allodynia
high output failure occurs with
anemia
The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of deep vein thrombosis (DVT). Which nursing intervention should the nurse implement?
apply sequential pneumatic compression devices to lower extremities
Which dysrhythmia has an atrial rate between 250 and 400, with saw-toothed P waves?
atrial flutter
A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to
avoid caffeinated beverages
Humoral control of blood flow involves the effect of vasodilator and vasoconstrictor substances in the blood. Select the factor that has a powerful vasodilator effect on arterioles and increases capillary permeability.
histamine
A patient has been diagnosed with congestive heart failure (CHF). The health care provider has ordered a medication to enhance contractility. The nurse would expect which medication to be prescribed for the patient?
digoxin
The school nurse is doing a health class on the functional organization of the circulatory system. What is the function of the capillaries in the circulatory system?
exchange gases and nutrients/wastes
The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client?
fluttering
A client with malignant hypertension is at risk for a hypertensive crisis, including the cerebral vascular system often causing cerebral edema. The nurse would assess this client for which signs and symptoms?
headache and confusion
A 20 year old female pricked her left hand while sewing: which area in her brain would have received the pain signal s and perceived them as pain?
right somatosensory cortex
The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from?
sinoatrial node
A client is diagnosed with a dysrhythmia at a rate slower than 60 beats/minute with a regular interval between 0.12 and 0.20 seconds. What type of dysrhythmia does the client have?
sinus bradycardia
Which one of the following organs are the two primary sites of lipoprotein synthesis?
small intestine, liver
A nurse working with a client in heart failure is explaining why the symptoms of the heart failure were not evident for a long period of time. When describing the Frank-Starling mechanism, the nurse will explain:
the relationship between venous return and stroke volume
50 yo obese male with hypertension and CAD visits nutritionist for food counseling. He is told that ____ fats raise LDL levels and lower HDL levels and should be avoided
trans-fat
The heart consists of four valves. Which are the heart's atrioventricular valves? Select all that apply.
tricuspid and mitral
Which serum biomarker is highly specific for myocardial tissue?
troponin
Which of the following is associated with stasis of blood, increased blood coagulability, and vessel wall injury?
venous thrombosis
Before a transesophageal echocardiogram, a nurse gives a client an oral topical anesthetic spray. When the client returns from the procedure, the nurse observes no active gag reflex. What nursing action is a priority?
withhold food and fluids.
